IndividualActive
Khyristienne Clark
NPI 1881574382 · Optometric Technician · Los Angeles, CA
Provider details
- NPI number
- 1881574382
- Entity type
- Individual
- Primary specialty
- Optometric TechnicianEye and Vision Services Providers
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
11301 Wilshire Blvd Bldg 304
Los Angeles, CA 90073-1003
Phone: (310) 478-3711
Approximate (ZIP-level) locationGet directions
Mailing address
9636 S Harvard Blvd
Los Angeles, CA 90047-3814
Registry dates
- Enumerated
- 2025-09-04
- Last updated
- 2025-09-04
- Certified
- 2025-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.